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来曲唑与枸橼酸氯米芬治疗不孕女性的妊娠结局及胎儿先天性异常发生率比较。

Comparison of the pregnancy outcomes and the incidence of fetal congenital abnormalities in infertile women treated with letrozole and clomiphene citrate.

作者信息

Akbari Sene Azadeh, Ghorbani Selma, Ashrafi Mahnaz

机构信息

Shahid Akbar Abadi Clinical Research Unit, Iran University of Medical Sciences, Tehran, Iran.

Abadi Hospital, Iran University of Medical Sciences, Tehran, Iran.

出版信息

J Obstet Gynaecol Res. 2018 Jun;44(6):1036-1041. doi: 10.1111/jog.13644.

Abstract

OBJECTIVES

The aim of the study was to evaluate the incidence of congenital fetal anomalies reported among infertile Iranian women treated with letrozole compared to those treated with Clomiphene Citrate (CC).

METHODS

This retrospective case-control study was performed based on information available from infertile patients referred to the Akbar-Abadi Hospital IVF Center, Tehran, Iran, undergoing ovulation induction (OI) or intrauterine insemination (IUI) cycles from 2007 to 2014.We compared sonographic findings, fertility results, pregnancy complications and congenital anomalies in two groups of women treated with letrozole and CC.

RESULTS

Overall, the results of the 2009 cycles including 1237 CC cycles and 772 letrozole cycles were evaluated. In spite of a higher chance of ovulation following CC treatment, overall fertility rates were similar in the two treatment groups. The frequency of adverse outcomes of pregnancy was similar in the two groups, except for the incidence of first trimester abortion, which was significantly higher in the CC-treated group. The frequency of fetal anomalies and major chromosomal abnormalities in the Letrozole group was 4.76% (five cases), and in the CC group, it was 2.12% (three cases). This difference was not statistically significant.

CONCLUSION

Based on the findings of this study, it seems that the incidence of congenital anomalies in offspring after OI with letrozole is not increased compared to the CC group.

摘要

目的

本研究旨在评估与接受枸橼酸氯米芬(CC)治疗的伊朗不孕女性相比,接受来曲唑治疗的不孕女性中报告的先天性胎儿异常的发生率。

方法

本回顾性病例对照研究基于2007年至2014年转诊至伊朗德黑兰阿克巴 - 阿巴迪医院试管婴儿中心接受促排卵(OI)或宫内人工授精(IUI)周期治疗的不孕患者的可用信息进行。我们比较了接受来曲唑和CC治疗的两组女性的超声检查结果、生育结果、妊娠并发症和先天性异常情况。

结果

总体而言,评估了2009个周期的结果,其中包括1237个CC周期和772个来曲唑周期。尽管CC治疗后排卵机会更高,但两个治疗组的总体生育率相似。除了早期流产发生率在CC治疗组显著更高外,两组妊娠不良结局的频率相似。来曲唑组胎儿异常和主要染色体异常的频率为4.76%(5例),CC组为2.12%(3例)。这种差异无统计学意义。

结论

基于本研究结果,与CC组相比,来曲唑促排卵后后代先天性异常的发生率似乎并未增加。

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